How are QALY (or utility) weights determined?
A number of methods have been used to determine QALY weights. In early applications of the approach, the QALY adjustment was often based on a relatively ad hoc judgment by researchers or clinicians, and was not based on the formal elicitation of a representative sample of individuals’ preferences.4, 5 Gerard et al (1999) 6 found that in 30% of the studies in a sample of 100 cost-utility analyses published in 1996, the source of the QALY weights was the researchers’ judgments or guesses. Early analysts advocated the determination of QALY weights through a socio-political process or by a ‘decision maker’ (i.e., representative of a government health department responsible for health resource allocation).7 However, there is now relatively widespread agreement that the preferences of the consumers of health care should be taken into account. There is less agreement about whose values and preferences should be elicited, or how preferences should be best measured.1, 8-11 Many authors argue fo
